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LDA guest editorial Dr. Thomas P. Conaty Vice Chairman (immediate past), ADA Council on Government Affairs Non-Professional Providers recently read “A History of Minnesota’s Dental I Therapist Legislation” written by the Minnesota Dental Association (MDA). This “history” lists 14 procedures that a dental therapist may perform as per the state’s statutes. The scope of practice includes cavity preparation, restoration of primary and permanent teeth, pulpotomies and extractions of primary teeth, as well as prescriptive authority. However, a dental therapist may not scale teeth without attending hygiene school because “the dental therapist educational program would have to be longer if it had to include all of the hygiene functions along with the surgical and restorative functions.” In other words, it’s legal for dental therapists to perform complex functions performed by dentists, but illegal to perform hygiene treatment. Please be assured that I do not intend to be critical of the MDA for what happened in their state after a long political fight in a very difficult environment. I feel certain they did the best that they could under overwhelming circumstances. In 1992, the American Dental Hygienists’ Association (ADHA) published “The Dental Hygienist as Change Agent.” This article delineated a strategic plan that included increased representation on boards, administration of local anesthesia, and also urged hygienists to seek independent dental hygiene practice so they could determine treatment plans and referrals. The ADHA also stated that “dentists do not have the professional expertise in dental hygiene to be effective dental hygiene regulators.” In a 1993 letter to Hillary Clinton, the California Dental Hygiene Association stated, “… hygienist(s) should provide the services they are currently allowed under general supervision, without the restraint of trade that comes from having to be employed by a dentist.” Hygienists have also argued that they should be the “gatekeepers” for dental services under a national health insurance plan. One of their first successes was in Colorado where they advocated for, and won, unsupervised hygiene practice to serve patients in impoverished areas. Today, only one of the 20 unsupervised hygienists work in underserved areas, and their fees are equal to or higher than the dentists who work in these communities. In recent years, as the issue of access to dental care has gained even greater national attention and the hygienists joined forces with health care coalitions, they began to achieve their goals. With “workforce change” agendas that are being funded by the Kellogg and Pew foundations and studies by the Institute of Medicine and HRSA (that do not include representatives from organized dentistry) for the purpose of “reorganizing the dental delivery system,” the radical hygienists have gained powerful allies. Our great profession needs to stand and fight the battle to prevent the encroachment by non-dentists performing irreversible dental treatment. We must educate ourselves to the realities of the greatest threat to dentistry in our 150 year history. Let’s arm ourselves with the critical knowledge to save and preserve for future generations the finest dental care in the world. We need an “attitude adjustment” to resist the sea of negativity that we are drowning in today. As I talk to my fellow dentists from across the country, I hear statements like – we are. the station. up on the menu. These attitudes will become, and in some cases have become, a self-fulfilling prophecy. We seem to have forgotten as a profession who we are and what we have endured and achieved to get to where we are. We have forgotten the great educational disparity between hygienists and dentists. As one of our national legislative advocates recently said, “Dentists seem to have lost confidence.” 2 LDA Journal
The question remains – how do we change the paradigm that has brought us to this point? A proactive approach would include the following: before the mid level dialog takes place. Medicaid, SCHIP and Safety net programs. disease before it occurs, we cannot “drill and fill” our way out of this epidemic. model – (chances are if you do this you will get non professional providers) – Educate, don’t compare. quality not affordability of care. supervision, education and training. Unfortunately, the final outcome for dentistry’s future in our country will be a political solution. It will not be based on facts. It will depend on the public’s perception of reality. The stage has been set to destroy the monumental advances of our profession. I urge every dentist to educate themselves and get involved in the political process. We can only win if we are willing to fight to preserve our profession. (Reprinted with the permission of Dr. Conaty.) AFTCO is the oldest and largest dental practice transition consulting firm in the United States. AFTCO assists dentists with associateships, purchasing and selling of practices, and retirement plans. We are much more than a practice broker, we are there to serve you through all stages of your career. Call 1-800-232-3826 for a free practice appraisal, a $2,500 value! Rebecca L. Blum, D.D.S. has acquired the practice of Amanda E. Haszinger, D.D.S. Kenner, Louisiana AFTCO is pleased to have represented both parties in this transaction. Helping dentists buy & sell practices for over 40 years. WWW.AFTCO.NET Winter 2010 3
Page 1: VOL. 69, NO. 4 WINTER 2010 Journal
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